Systematic Review of Silk Scaffolds in Musculoskeletal Tissue Engineering Applications in the Recent Decade

Abstract

During the past decade, various novel tissue engineering (TE) strategies have been developed to maintain, repair, and restore the biomechanical functions of the musculoskeletal system. Silk fibroins are natural polymers with numerous advantageous properties such as good biocompatibility, high mechanical strength, and low degradation rate and are increasingly being recognized as a scaffolding material of choice in musculoskeletal TE applications. This current systematic review examines and summarizes the latest research on silk scaffolds in musculoskeletal TE applications within the past decade. Scientific databases searched include PubMed, Web of Science, Medline, Cochrane library, and Embase. The following keywords and search terms were used: musculoskeletal, tendon, ligament, intervertebral disc, muscle, cartilage, bone, silk, and tissue engineering. Our Review was limited to articles on musculoskeletal TE, which were published in English from 2010 to September 2019. The eligibility of the articles was assessed by two reviewers according to prespecified inclusion and exclusion criteria, after which an independent reviewer performed data extraction and a second independent reviewer validated the data obtained. A total of 1120 articles were reviewed from the databases. According to inclusion and exclusion criteria, 480 articles were considered as relevant for the purpose of this systematic review. Tissue engineering is an effective modality for repairing or replacing injured or damaged tissues and organs with artificial materials. This Review is intended to reveal the research status of silk-based scaffolds in the musculoskeletal system within the recent decade. In addition, a comprehensive translational research route for silk biomaterial from bench to bedside is described in this Review.

Advanced mycelium materials as potential self-growing biomedical scaffolds

“…Polysaccharides and protein polymers, such as chitin 28 , alginate 29 , hyaluronic acid 30 , 31 , silk 32 , 33 , and keratin 9 display biochemical guidance for cell migration, overcoming the lack of targeting for the attachment, typical of the aforementioned synthetic polymers 34 . Indeed, the hydroxyl groups present in polysaccharides and the fibronectin-specific amino acid sequences (RGD: Arginine–Glycine–Aspartic acid, and LDV: Leucine-Aspartic acid-Valine) displayed by protein-based biomaterials have proven to be extremely important for a successful cell adhesion 35 , 36 .…”

Multifunctional polyphenol-based silk hydrogel alleviates oxidative stress and enhances endogenous regeneration of osteochondral defects

“…Silk fibroin (SF) of Bombyx mori ( B. mori ) silkworm, a U.S. Food and Drug Administration (FDA)-approved biomaterial, has been widely used in tissue engineering applications due to its wide range of properties including good biocompatibility, excellent mechanical strength, adjustable degradation, and non-inflammatory by-products [ [13] , [14] , [15] ]. Among the multiple SF scaffolds developed for osteochondral tissue engineering, SF hydrogels have gained considerable attention due to their high-water content and 3D porous structure which are similar to the natural extracellular matrix (ECM) [ 16 , 17 ]. Previous studies have shown that functionalized SF hydrogels could regulate stem cell behaviors such as cell migration, proliferation, and differentiation [ 18 , 19 ].…”

Multiomics reveal that silk fibroin and sericin differentially potentiate the paracrine functions of mesenchymal stem cells and enhance tissue regeneration

“…The degummed silk (i.e., SF) has long been recognized as a promising biomaterial and has been widely used for tissue engineering applications. We and other researchers have developed various formats of SF scaffolds for the repair and regeneration of bone, cartilage, skin, cornea, etc (9)(10)(11)(12). In contrast, SS was previously regarded as a waste material during degumming and was found to cause immunological responses when combined with SF (13).…”